Recent progress in the search for GPIIb/IIIa antagonists having a predictable antithrombotic effect, preferably with a longer half-life (to achieve consistent levels of inhibition of platelet aggregation), has resulted in new antithrombotic dual inhibitors which have a mixed pharmacological profile. These new compounds inhibit two key targets in both the coagulation cascade (factor Xa) and the platelet aggregation pathway (GpIIb/IIIa) (described in EP 1574516).
As a precautionary measure, within the field of anticoagulant and anti-atherothrombotic therapy, there is a need for an antidote to be able to effectively neutralize or minimize the activity of the anticoagulant or anti-atherothrombotic drug used. This is because it is well known that a hemorrhage can be triggered in a patient under treatment for any accidental cause. Further, it may be necessary to intervene surgically in a patient under anti-atherothrombotic or anticoagulant treatment. In addition, during some surgical procedures, anticoagulants may be used at a high dose so as to prevent blood coagulation and it is necessary to neutralize them at the end of the operation. Further, clinically effective antidotes are not yet available in anti-platelet therapy wherein GpIIb/IIIa inhibitors are used. It is therefore advantageous to have anti-atherothrombotic and/or anticoagulant agents available which can be neutralized in order to stop the anti-atherothrombotic and/or anticoagulant activity at any time.
In US 2004/0024197 (WO02/24754) it is disclosed that, in case of emergency, the anticoagulant activity of certain polysaccharides may be partially reduced using avidin, if those polysaccharides contain at least a covalent bond with biotin or a biotin derivative.
O. Roger et al. in Carbohydrate Polymers 50 (2002) 273-278 discuss carbohydrate derivatisation by reductive amination, including biotinylation agents. The disclosure relates to the aselective modification of polydisperse natural polysaccharides.